ReviewJournal of intensive care2017
Evaluation of cough peak expiratory flow as a predictor of successful mechanical ventilation discontinuation: a narrative review of the literature.
Review in Journal of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Efficacy of functional electrical stimulation alone and as an adjunct to exercise for improving respiratory function and aerobic capacity in spinal cord injury: a systematic review and meta-analysis.Frontiers in rehabilitation sciences · 2025Pooled it
- Efficacy of Physiotherapy Interventions on Weaning in Mechanically Ventilated Critically Ill Patients: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Cough peak flow to predict extubation outcome: a systematic review and meta-analysis.Revista Brasileira de terapia intensivaPooled it
- Abdominal functional electrical stimulation to assist ventilator weaning in critical illness: a double-blinded, randomised, sham-controlled pilot study.Critical care (London, England) · 2019Trial
- Association between abdominal muscle weakness and weaning failure in mechanically ventilated critically ill patients: an ultrasound assessment.Journal of anesthesia, analgesia and critical care · 2026Article
- Factors associated with weaning success from prolonged mechanical ventilation in surviving Chinese pediatric intensive care units: a multicenter analysis.Frontiers in pediatrics · 2026Article
- Bedside Assessment of the Respiratory System During Invasive Mechanical Ventilation.Journal of clinical medicine · 2024Review
- Lower peak expiratory flow rate is associated with a higher risk of pneumonia in patients with stroke.European journal of physical and rehabilitation medicine · 2024Observational
- Assessing the reproducibility and predictive value of objective cough measurement for successful withdrawal of invasive ventilatory support in adult patients.BMC pulmonary medicine · 2024Observational
- Relationship between motor dysfunction, the respiratory muscles and pulmonary function in stroke patients with hemiplegia: a retrospective study.BMC geriatrics · 2024Article
- Pulmonary rehabilitation in the intensive care unit using surface electromyography in a patient with diaphragmatic injury: A case report.Turkish journal of physical medicine and rehabilitation · 2023Article
- Cough Peak Flow Assessment: Is There More to the Story?Respiratory care · 2023Article
- Cough Peak Flow Assessment Without Disconnection From the ICU Ventilator in Mechanically Ventilated Patients.Respiratory care · 2023Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020).Journal of intensive care · 2021Article
- Value of Peak Expiratory Flow Rate in Evaluating Cough Ability in Patients Undergoing Lung Surgery.Canadian respiratory journal · 2021Article
- Comparison of "cough peak expiratory flow measurement" and "cough strength measurement using the white card test" in extubation success: A randomized controlled trial.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2020Article
- Cough peak flow to predict the extubation outcome: Comparison between three cough stimulation methods.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2020Article
- Reduction of ventilatory time using the multidisciplinary disconnection protocol. Pilot study.Revista latino-americana de enfermagem · 2019Article
- [Advances in respiratory assessment and treatment in children undergoing invasive mechanical ventilation].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2019Review
- Risk factors and outcomes for airway failure versus non-airway failure in the intensive care unit: a multicenter observational study of 1514 extubation procedures.Critical care (London, England) · 2018Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A crucial step in the transition from mechanical ventilation to extubation is the successful performance of a spontaneous breathing trial (SBT). The American College of Chest Physicians (ACCP) Guidelines recommend removal of the endotracheal tube upon successful completion of a SBT. However, this does not guarantee successful extubation as there remains a risk of re-intubation. Guidelines have outlined ventilator liberation protocols, selected use of non-invasive ventilation on extubation, early mobilization, and dynamic ventilator metrics to prevent and better predict extubation failure. However, a significant percentage of patients still fail mechanical ventilation discontinuation. A common reason for re-intubation is having a weak cough strength, which reflects the inability to protect the airway. Evaluation of cough strength via objective measures using peak expiratory flow rate is a non-invasive and easily reproducible assessment which can predict extubation failure. We conducted a narrative review of the literature regarding use of cough strength as a predictive index for extubation failure risk. Results of our review show that cough strength, quantified objectively with a cough peak expiratory flow measurement (CPEF), is strongly associated with extubation success. Furthermore, various cutoff thresholds have been identified and can provide reasonable diagnostic accuracy and predictive power for extubation failure. These results demonstrate that measurement of the CPEF can be a useful tool to predict extubation failure in patients on MV who have passed a SBT. In addition, the data suggest that this diagnostic modality may reduce ICU length of stay, ICU expenditures, and morbidity and mortality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.